Raised ALT and GGT after surgery but worried about Hepatitis/other illnesses

[GBB82]

Hi,

I have been feeling unwell for a while, which I think is mostly anxiety. Nausea throughout the day, a bit of fatigue and sweating at night. I went away with friends and had a very hard drinking weekend, the week after until the present day (3 months) has been horrible. Nausea and fatigue mostly. I don't think a lot under 'normal' circumstances. I haven't had unprotected sex and I am not a drug user. The question is, I had leg surgery 5 days after providing bloods - ankle reconstruction with some work on my calf too. The 5 day post surgery ALT was 171 and GGT was 100 - these seem really high - I am worried about Hep A/B and less so C - would these numbers suggest something sinister or is it more likely the medication? I had GA plus paracetamol, tetracycline (antibiotics), ibuprofen, oral morphine, codeine, pragabalin and clexane at the time of the test.

Thank you

[GBB82]

I should say I haven't had unprotected sex but I have had sexual contact

[mtk0925]

I would redo the blood work in a few weeks and see if they have come down. And ask for a hepatitis panel test as well if you’re worried. I had Hep A after a vacation out of the country and it cleared up fast

[GBB82 in reply to mtk0925]

Hi, bloods back today from yesterday- So, three weeks after the ALT of 171 and GGT of 120 I am now down to ALT of 40, combined ALT and AST of 60, 0 GGT, ALP normal apparently. Plasma CRP was 0, too. Thinking this is normal? Although ALT seems a little high?

[mtk0925 in reply to GBB82]

seems like it’s coming down

[Kristian]

I think all those meds you were taking at the time could have an impact on the liver. The poor blighter was getting bombarded, lol. So seeing raised liver test levels is not too unsurprising. It's a case of the short term impact isn't likely to cause any long term issues.

It is though worth getting your bloods redone after you finish the meds. Just to be on the safe side and to make sure there isn't an underlying issue present.

In describing your symptoms, it could also be the case that you picked up some sort of infection also. There's quite a few that can lead to temporary hepatitis. Feels rough at the time but again doesn't lead to lasting damage.

If you are still having the symptoms then its worth seeing the gp anyway. Either to rule out an infection or to just check that you aren't adversely reacting to any of your meds.

Hope thats helpful.

[GBB82 in reply to Kristian]

Thank you. I have some pain in my back, just on the right hand side and only a couple of times a day (mainly when sat down). I have read in a few places it is unlikely to be the liver in this case as it will almost certainly come with abdominal pain, too?

[GBB82 in reply to Kristian]

Kristian So, three weeks after the ALT of 171 and GGT of 120 I am now down to ALT of 40, combined ALT and AST of 60, 0 GGT, ALP normal apparently. Plasma CRP was 0, too. Thinking this is normal? Although ALT seems a little high?

[Kristian in reply to GBB82]

Reference ranges between labs vary but the key thing is the change. If they are reducing then docs tend not to be too concerned particularly if they are approaching or within the normal ranges. ALT of 40 is generally around the top end of the normal range, so again I suspect the docs wouldn't be overly concerned, particular given it was 171 at the previous test.Its always worth getting a view from your doc on the results just to confirm all is OK. But, if it was me, I wouldn't be overly concerned.

[GBB82 in reply to Kristian]

They put note - 'Normal, no concern'. Hep A, B, C results due next week. I would expect a far higher ALT than 171 and certainly 40 with acute Hep I think? Kristian thank you for taking time to reply

[Kristian in reply to GBB82]

No probs, happy to help. And, yes, acute hepatitis would give much much higher results, lol.

[GBB82]

So, three weeks after the ALT of 171 and GGT of 120 I am now down to ALT of 40, combined ALT and AST of 60, 0 GGT, ALP normal apparently. Plasma CRP was 0, too. Thinking this is normal? Although ALT seems a little high?